Establishment of occlusal relationship in rpd/ colleges for dentistry

“Establishment of Occlusal
Relationship in Removable Partial
Dentures”
1
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

© 2003 By Default!
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Slide 2
Contents
•Diagnosis & treatment planning
•Articulator selection
•Jaw relation recording & interocclusal
record
•Selection of denture teeth
•Choice of Occlusal schemes & morphologies
•Objectives for establishing occlusal schemes
•Occlusal morphologies
•Plane of orientation
•Determining the occlusal scheme
•Summary & conclusion 2

Introduction
•Any partially edentulous
situation is a derailment of
occlusion
3

INTRODUCTION:
Introduction
•The natural & artificial dentition
must coexist functionally &
esthetically in a harmonious
relationship
•The knowledge, judgment,
understanding & skill of each
dentist is more important in
treating patients rather than
the techniques or concept of
occlusion
4

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•A review of patients
medical & dental history
Diagnosis & treatment planning:
•A complete clinical
examination
•Mounted diagnostic cast on a semi
adjustable articulator using face bow
transfer & interocclusal record.
5

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Preprosthetic treatment
6

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Analyzing & correction of occlusal plane
•Orthodontic tooth movement
•Intentional devitalization
•periodontal surgeries
•Selective occlusal adjustment
7

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Treatment modalities
•No prejudice
towards any
particular occlusion
•Both group function & mutually
protected articulation exists in
natural dentition
•Alteration of existing physiologic
state may create a traumatic
occlusion 8

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Articulator selection
•Information regarding occlusal
analysis
•Aids in diagnostic wax up
•Assists in final treatment plan
Diagnostic phase
9

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Treatment phase
•Fabrication of physiologic cusp
•Correct tooth positioning
•Relate casts in static relation to the
Condyle & stimulate eccentric movements
10

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Jaw relation recording
•If sufficient opposing posterior natural
teeth present, cast can be hand
articulated.
11

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•When there are sufficient natural
teeth present but the opposing teeth
cannot be occluded in a stable
position,partial record blocks are made
& an indentation of opposing natural
teeth taken
12

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•If there not sufficient opposing
natural teeth, jaw relation need to be
recorded with the occlusal rims &
interocclusal record as in complete
denture
13

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Interocclusal records
•Interocclusal orientation required to
orient the maxillary & mandibular
diagnostic & master cast
•Interocclusal relation not required if
sufficient occlusion remains to provide
stable cast to cast relation
•A record base,occlusal rim & occlusal
recording medium necessary to make
an accurate record 14

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Interocclusal record contd.
•Centric relation position or maximum
intercuspation
•Establishment of vertical dimension of
occlusion
•Should allow positive alignment of
cast
•Dimensionally stable
•Minimal displacement of tissues
•Easy manipulation 15

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Selection of denture teeth
•Acrylic resin
•Porcelain
•Metal
16

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Choice of occlusal schemes &
morphologies
Occlusal schemes
•Mutually protected articulation
•Canine protected articulation
•Centric occlusion coincide with
centric relation
•Group function articulation
•Neutrocentric articulation
17

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Objectives for establishing occlusal
schemes
•Tooth supported or tooth –tissue
supported situation maximum intercuspal
position should be maintained
•Bilateral simultaneous
contacts of teeth in
posterior position ,
anterior contact should
be passive in maximum
intercuspation 18

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•In protrusive movement anterior
clearance should be present
schemes contd.
•If possible patients
existing occlusal scheme in
lateral movement should
not be altered
•When remaining natural canines are
present & periodontally sound ,canine
protected articulation is preferred 19

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schemes contd.
•In case of missing or periodontally
weak canines, group function
articulation is preferred.
•Non working contacts on
natural teeth should not
be established
•When periodontally sound natural
anterior teeth present, no posterior
contact in protrusive movement 20

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Occlusal morphologies
•Zero degree or monoplane teeth
•Semianatomic (10o
– 30o
)
•Fully anatomic (30o
– 45o
)
Based on the occlusal morphologies
•Balanced articulation
•Monoplane articulation
21

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Monoplane teeth
•Seldom indicated in removable partial
unless they oppose a similar
articulation
Indications
22

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Anatomic teeth contd.
Indications
•Where esthetics is of primary concern
•Where balanced or group function
articulation is desired
•Anterior guidance due to presence of
natural teeth
•Cuspal inclination of existing natural
teeth
23

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Semianatomic teeth
•10o
– 30o
cuspal inclination
Plane of orientation
•Class III & class IV situation plane
of orientation determined by existing
natural dentition
24

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Plane of orientation contd.
•Class I & class II situation plane of
orientation determined by cusp tip of
the distal most natural teeth up to
anterior 23 of retromolar pad
•In case of inadequate interocclusal
space or weaker arch alteration in plane
of orientation required. 25

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Determining the occlusal scheme
Kennedy's class III situation
•Occlusal morphology of the artificial
teeth selected to match that of the
opposing teeth. 26

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•If existing occlusion healthy, patient
is restored to the existing occlusal
scheme
27

•Natural canine missing or periodontally
Compromised group function is indicated
28

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Kennedy's class III situation Contd.
•Balanced articulation recommended if
Restoration opposing complete denture
29

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Kennedy's class II situation contd.
•Presence of periodontally sound
canine, canine guided occlusion should
be given
31

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•Except opposing a complete denture
Balanced articulation should be
avoided
Kennedy's class II situation contd.
•Absent or periodontally weak canine
group function should be given
32

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Kennedy's class I situation
•Balanced articulation is indicated
when Canine guided articulation is
not possible
33

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Kennedy's class IV situation
•Passive tooth contact
in both centric
& eccentric movement
•Balanced articulation against
a complete
Denture with protrusive
contacts of the
anteriors 34

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Kennedy's class V situation
•Presence of periodontally sound
canine, canine guided occlusion should
be given
35

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Kennedy's class VI situation
•Same as class III situation
•If existing occlusion healthy,
patient is restored to the
existing occlusal scheme
•Natural canine
missing or
periodontally
Compromised, group
function is indicated 36

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Summary
•Selected scheme must be capable of
functioning Within the pattern of
patient’s own functional requirements
•Opposing contacting teeth should glide
Freely without cuspal interference
37

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•The appropriate jaw relation suitable
for the situation, whether it is centric
relation or centric occlusion should be
determined in the diagnostic phase &
attempts to create an artificial occlusal
surface should be preceded by the
elimination of any occlusal
discrepancies in the natural teeth
38

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•The combined occlusal pattern of
natural & artificial teeth function
harmoniously with other parts of
masticatory system
39

conclusion
•In the restoration of partial edentulousIn the restoration of partial edentulous
situations it is essential that both thesituations it is essential that both the
natural & the artificial dentition shouldnatural & the artificial dentition should
maintain a harmonious relationmaintain a harmonious relation
•There should be even contact & no
undue contact forces should be exerted
on any part of the restoration
•If possible restoration should be done
in the patients existing physiologic state
40

41
Thank you
For more details please visit
www.indiandentalacademy.com

© 2003 By Default!
Slide 42
ReferencesReferences
 ““Removable Partial Prosthodontics”-Mc Cracken’sRemovable Partial Prosthodontics”-Mc Cracken’s
 ““Clinical Removable Partial Prosthodontics”-Clinical Removable Partial Prosthodontics”-
Stewart, Rudd et al.Stewart, Rudd et al.
 ““Occlusion in Removable Partial Prosthodontics”-Occlusion in Removable Partial Prosthodontics”-
JPD-2004:91:1-5JPD-2004:91:1-5
 ““Colour atlas of removable partial denture”-GeorgeColour atlas of removable partial denture”-George
grabergraber
 ““Colour atlas of removable Partial Dentures”-Colour atlas of removable Partial Dentures”-
J.C.Davenport & Basker.J.C.Davenport & Basker.
 ““Dental Laboratory Procedures” Rudd & MorrowDental Laboratory Procedures” Rudd & Morrow
 ““Removable Prosthodontics” – DCNA 2004;48:3Removable Prosthodontics” – DCNA 2004;48:3
42

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